Piqray (alpelisib)
Patient Assistance Program Guide — Novartis Patient Assistance Foundation (NPAF)
Do You Qualify?
Income
Up to $75,300 for a single person
Insurance
Available to uninsured, underinsured, or Medicare Part D patients who meet financial criteria. Patients with commercial insurance must first seek assistance through the co-pay savings program.
Residency
U.S. resident, including Puerto Rico and U.S. territories, with a valid U.S. address.
Income Limits (500% FPL)
Income limits are calculated at 500% of the 2025 FPL for NPAF Oncology programs.
Based on 2025 HHS Federal Poverty Level guidelines.
# Getting Piqray (Alpelisib) at No Cost Through the Novartis Patient Assistance Foundation (NPAF)
Who Qualifies for the Novartis Patient Assistance Foundation (NPAF)?
If you need Piqray (alpelisib) but cannot afford it, you may be able to get it at no cost through the Novartis Patient Assistance Foundation (NPAF). This program provides free medication directly to eligible patients who meet financial and insurance requirements. To qualify, your annual household income must generally be at or below $75,300 for a single-person household — though limits are higher for larger households. In terms of insurance, you must be uninsured, underinsured, or enrolled in Medicare Part D to apply directly to NPAF. If you have commercial insurance, Novartis requires you to first apply through their co-pay savings program before seeking foundation assistance.
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About Piqray (Alpelisib)
Piqray (alpelisib) is a prescription medication approved by the FDA to treat hormone receptor-positive (HR+), HER2-negative advanced or metastatic breast cancer in patients whose tumors have a specific genetic change called a PIK3CA mutation. It belongs to a class of drugs called PI3K inhibitors and is taken orally, typically in combination with another medication. Piqray is a specialty drug, which means it is manufactured through a complex process and carries a high price tag — often tens of thousands of dollars per year without insurance or assistance. For many patients, out-of-pocket costs would be unmanageable without programs like NPAF.
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Income Eligibility: Full Breakdown
NPAF uses income limits set at 500% of the 2025 Federal Poverty Level (FPL) for its oncology programs. The table below shows the maximum annual income allowed based on your household size:
| Household Size | Max Annual Income |
|---|---|
| 1 person | $75,300 |
| 2 persons | $102,200 |
| 3 persons | $129,100 |
| 4 persons | $156,000 |
Your income is typically verified using your most recent federal tax return (Form 1040) or three months of recent pay stubs. If you receive Social Security, a Social Security award letter may also be accepted. Household size generally includes everyone living in your home who shares financial resources, so be sure to count dependents accurately — a larger household size raises your income limit, which may help you qualify even if your income seems high at first glance.
If your income is above these limits, you may not qualify for NPAF directly. However, there are other options available, which are covered in the "Alternatives If You Don't Qualify" section below.
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Insurance Requirements Explained
Your insurance status plays a major role in whether you can apply to NPAF and what path to take:
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Step-by-Step: How to Apply
Follow these steps to apply for free Piqray through NPAF:
1. Confirm your eligibility. Review the income limits and insurance requirements above. If you believe you qualify, move forward with the application.
2. Gather your required documents. You will need:
- Your most recent federal tax return (Form 1040)
- Proof of income (W-2 forms, recent pay stubs, or a Social Security award letter)
- A completed and signed NPAF application form (signed by both you and your prescribing doctor)
- A valid prescription for Piqray from your doctor
3. Get the application form. Download or request the NPAF application by visiting https://www.novartis.com/us-en/patients-and-caregivers/patient-assistance/novartis-patient-assistance-foundation or by calling (800) 277-2254.
4. Complete the form with your doctor. Both you and your prescriber must sign the application. Your doctor's office may be able to help coordinate this step.
5. Submit your application. You can apply:
- Online at the link above
- By fax to (866) 817-1485
- By phone at (800) 277-2254
6. Wait for a decision. Processing typically takes 2 to 3 business days after your complete application is received.
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What to Expect: Timeline and Delivery
Once your application is submitted with all required documents, a decision is typically made within 2 to 3 business days. You or your doctor's office will be notified of the outcome. If approved, your Piqray will be shipped directly to your home address — you do not need to pick it up at a pharmacy or prescriber's office. Make sure someone is available to receive the shipment, as specialty medications often require a signature. Your approval is valid for one year. Before that period ends, you will need to reauthorize your enrollment annually by submitting updated income documentation and a renewed application to continue receiving the medication at no cost.
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Alternatives If You Don't Qualify
If you do not qualify for NPAF, here are other options worth exploring:
1. Biosimilar alternatives: There are currently no FDA-approved biosimilar versions of Piqray (alpelisib) available. This option is not available at this time.
2. Manufacturer savings card for insured patients: If you have commercial insurance, Novartis offers a Piqray co-pay savings card that may reduce your out-of-pocket costs significantly. You can enroll at https://www.piqray.com/financial-support.
3. State Pharmaceutical Assistance Programs (SPAPs): Many states run their own drug assistance programs, especially for older adults or people with disabilities. Eligibility and benefits vary by state. Contact your state health department or ask your doctor's office for a referral.
4. NeedyMeds.org: This free, independent database at www.needymeds.org lists hundreds of assistance programs by drug name, condition, and state. It is a helpful starting point if NPAF is not the right fit for your situation.
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*This guide is for informational purposes only and does not constitute medical or legal advice. Eligibility determinations are made solely by Novartis. Program terms may change — verify current requirements at [https://www.piqray.com/patient-support](https://www.piqray.com/patient-support) before applying.*
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Documents You'll Need
If You Don't Qualify for the Assistance Program
Manufacturer Savings Card (for insured patients)
Novartis offers a savings card that may reduce your out-of-pocket cost if you have commercial insurance. Ask your prescriber or pharmacist for current savings card details.
Common Questions
Processing typically takes 2 to 3 business days after Novartis receives your complete application. Make sure all required documents — including your tax return, proof of income, signed application, and prescription — are included to avoid delays.
Yes. Unlike some patient assistance programs, the Novartis Patient Assistance Foundation does accept patients who are enrolled in Medicare Part D, as long as you also meet the income requirements for your household size.
You will need your most recent federal tax return (Form 1040) and at least one form of income verification, such as W-2 forms, recent pay stubs, or a Social Security award letter. Both you and your prescriber must also sign the NPAF application form.
Yes. If you are approved, Piqray is shipped directly to your home address. You do not need to visit a pharmacy or your doctor's office to pick it up. Be prepared to sign for the delivery, as specialty medications often require a signature upon receipt.
Your NPAF enrollment must be reauthorized every year. Before your approval expires, you will need to submit a new application along with updated income documentation. Your doctor will also need to sign the renewal form. It is a good idea to start this process several weeks before your current approval ends to avoid any gap in your medication.
Ready to Apply for Piqray Assistance?
RX Advantages handles the entire Novartis Patient Assistance Foundation (NPAF) application on your behalf — paperwork, physician coordination, and refill tracking. It takes about 15 minutes to get started.
No SSN required on the web form · From $49.95/month